Evaluation of trends in breast cancer–related content on TikTok

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Background: Social media plays an important role in disseminating information to patients. It is important to investigate the healthcare content on popular platforms to understand the material consumed by patients that may influence their medical decision making. TikTok has over 1 billion monthly active subscribers and has become common ground to communicate healthcare information, including that of breast cancer. This study aims to provide an analysis of breast-cancer related information on TikTok. Methods: The most popular TikTok hashtag related to breast cancer was identified, and the top videos were gathered on January 23, 2022. Data was collected to reach a target of 100 videos. Exclusion criteria were non-English videos, repeated videos, or upload of movie/tv clip without educational info. The video source was characterized based on healthcare role, gender, and race. Healthcare provider was defined as an individual with a professional medical degree (MD, PA, RN, other). The videos were categorized into patient experience, educational, advertisement, and other. Specific content components, including chemotherapy, surgical intervention, mammogram, and self-breast exam, were tracked. Results: The hashtag “#breastcancer” was identified as the most popular, with 773.8 million views. The videos had a combined 258,886,300 views, 31,573,400 likes, 413,604 shares, and 567,520 comments. Of the 100 videos analyzed, 91 were uploaded by a layperson, 2 by a healthcare professional, and 7 by a company. The healthcare professionals consisted of one OB/GYN and one general surgeon. The racial designations of the main subjects in the videos were 87.2% White, 3.2% Black, 2.1% Hispanic, 4.3% Asian, and 3.2% undetermined. Content categorization revealed 81% patient experience, 22% educational, 6% advertisement, and 8% other. The major topics presented in the videos related to surgical treatment (39%), chemotherapy (37%), and radiation treatment (2%). Conclusions: An overwhelming majority of breast cancer related information on TikTok was not presented by qualified healthcare professionals and exhibited a lack of cultural diversity and inclusivity.[Table: see text]

Estimating patient demand for oncologists in the United States using Google trends

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Background: Cancer accounts for a massive burden of global disease, healthcare expenditure, and is one of the leading causes of death worldwide, accounting for approximately 1 in 6 deaths. As both the incidence and prevalence of cancer continue to increase, along with the percentage of the population over the age of 65, it is important to understand patient demand for oncologists. Previous studies have predicted a shortage of over two thousand oncologists by 2025. The inconsistencies between supply and demand for oncologists require analysis and supervision to identify potential gaps in oncological care and fulfill patient demand for quality care. Methods: The average relative search volume (RSV) for the term “oncologist” was determined by analyzing Google Trends from 2004-2019 for each state. The oncologist per capita values were computed by taking the number of oncologists per state and then dividing by the corresponding 2019 Census estimates. The RSV values were then divided by per capita values to quantify demand index and standardized to generate a relative demand index (RDI). A spearman’s rho correlation test was also conducted to assess the relationship between RDI and overall 2019 state health rankings as conducted by the America’s Health Rankings group. Results: The states with highest RSV was New Jersey (100), Florida/Tennessee (98), and Connecticut (97), while the lowest RSV were Oregon (53), Alaska (44), and Vermont (41). The RDI for oncologists was greatest in Idaho (100), Mississippi (86), and Arkansas (77) while the lowest were for Vermont (15), Massachusetts (14), and District of Columbia (8). Spearman’s rho test revealed a strong negative relationship between RDI and overall state health ranking that was statistically significant (rs= -0.6363, p < 0.001). Conclusions: These trends may give us a preliminary idea of states that have unmet healthcare needs in oncology. Further studies are warranted.

Readability Analysis of the American Society of Ophthalmic Plastic & Reconstructive Surgery Patient Educational Brochures

INTRODUCTION

Previous studies have shown patient education material (PEM) in ophthalmology has been written at levels exceeding appropriate reading levels. However, information for readability in the field of oculoplastics remains limited. The aim of this study was to evaluate the readability of patient educational brochures from the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS).

METHODS

Patient educational brochures from ASOPRS were analyzed for readability. The body of text from all 18 ASOPRS patient brochures was analyzed by ten validated tests for English readability assessment: Flesch Reading Ease Test (FRE), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), Gunning Fog Index (GFI), New Dale-Chall Readability (NDC), FORCAST, Fry Graph Readability (FG), Raygor Readability Estimate (RRE), and New Fog Count (NFC).

RESULTS

The mean (± SD) readability scores from the 18 ASOPRS patient brochures were 48 (4.3), 11.0 (0.8), 13.0 (0.7), 11.7 (0.8), 13.6 (0.9), 11.3 (0.8), 11.1 (0.5), 12.1 (1.5), 12.2 (1.0), and 10.6 (1.3) for FRE, FKGL, SMOG, CLI, GFI, NDC, FORCAST, FG, RRE, and NFC, respectively. All ten of the mean readability scores were above the recommended reading levels.

CONCLUSIONS

These findings show that the average patient may have difficulty understanding educational information provided by ASOPRS patient brochures, thereby hindering their ability to make informed decisions on their healthcare. Revision with readability as a primary goal, with input from patients and caregivers, may be necessary to improve health literacy among patients who seek oculoplastic care.

Localized Versus Generalized Granuloma Annulare: A Retrospective Review of 407 Patients

BACKGROUND

Granuloma annulare has been linked to diabetes, dyslipidemia, thyroid disease, collagen vascular disease, malignancies, infectious hepatitis, and systemic infections. However, these associations have not been systematically investigated when categorized by its clinical variants.

OBJECTIVE

To evaluate disease associations of localized and generalized granuloma annulare.

METHODS

In total, 407 granuloma annulare patients from 1989 to 2019 were retrospectively reviewed, categorized by clinical variant (localized or generalized), age (pediatric or adult), and diagnostic method (clinical or histologic). Descriptive statistical analyses and multivariate logistic regression analysis were performed. Fisher's exact tests were conducted to produce unbiased probability values.

RESULTS

Overall, 75.2% of the study sample was female, 47.2% had dyslipidemia, 24.8% were diabetic, and 24.6% had thyroid disease. Dyslipidemia (OR 2.15, CI 1.95-2.35, P < .001), diabetes (OR 1.16, CI 1.01-1.31, P = .041), and histologic diagnosis (OR 2.08, CI 1.21-3.52, P = .007) were associated with increased risk of GGA compared to LGA. When stratified by adult versus pediatric cases, dyslipidemia and diagnostic method remained significant, but diabetes did not.

CONCLUSIONS

Evaluating granuloma annulare by its clinical variants may help to determine disease associations with each variant.

Metabolic signature of eyelid basal cell carcinoma

PURPOSE

Eyelid basal cell carcinoma (BCC) is the most common eyelid malignancy. Metabolic reprogramming is critical in tumorigenesis, but the metabolic feature of eyelid BCC remains elusive. In this study, we aim to reveal the metabolic profile in eyelid BCC using targeted metabolomics. Eyelid samples were collected from patients who had removal of BCC and from control patients who underwent blepharoplasty. Multivariate analysis of metabolomics data distinguished the two groups, indicating that eyelid BCC has significantly different metabolome than the healthy tissue. We found 16 increased and 11 decreased metabolites in the BCC tissues. These metabolites were highly enriched in the metabolism of nicotinamide adenine dinucleotide (NAD), glutathione metabolism, polyamine metabolism, and the metabolism of glycine, serine, threonine, arginine and proline. amino acid metabolism. Metabolites from NAD metabolism (Nicotinamide; Nicotinamide riboside; N1-Methylnicotinamide) had the highest sensitivity, specificity, and prediction accuracy in a prediction model for eyelid BCC. In conclusion, eyelid BCC has a signature change of cell metabolome. Metabolites in NAD metabolic pathways could potentially be biomarkers or therapeutic targets for eyelid BCC.

Regulating microRNA expression: at the heart of diabetes mellitus and the mitochondrion

Type 2 diabetes mellitus is a major risk factor for cardiovascular disease and mortality. Uncontrolled type 2 diabetes mellitus results in a systemic milieu of increased circulating glucose and fatty acids. The development of insulin resistance in cardiac tissue decreases cellular glucose import and enhances mitochondrial fatty acid uptake. While triacylglycerol and cytotoxic lipid species begin to accumulate in the cardiomyocyte, the energy substrate utilization ratio of free fatty acids to glucose changes to almost entirely free fatty acids. Accumulating evidence suggests a role of miRNA in mediating this metabolic transition. Energy substrate metabolism, apoptosis, and the production and response to excess reactive oxygen species are regulated by miRNA expression. The current momentum for understanding the dynamics of miRNA expression is limited by a lack of understanding of how miRNA expression is controlled. While miRNAs are important regulators in both normal and pathological states, an additional layer of complexity is added when regulation of miRNA regulators is considered. miRNA expression is known to be regulated through a number of mechanisms, which include, but are not limited to, epigenetics, exosomal transport, processing, and posttranscriptional sequestration. The purpose of this review is to outline how mitochondrial processes are regulated by miRNAs in the diabetic heart. Furthermore, we will highlight the regulatory mechanisms, such as epigenetics, exosomal transport, miRNA processing, and posttranslational sequestration, that participate as regulators of miRNA expression. Additionally, current and future treatment strategies targeting dysfunctional mitochondrial processes in the diseased myocardium, as well as emerging miRNA-based therapies, will be summarized.